Revista médica de Chile
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Revista médica de Chile · Sep 2020
[Magnetic resonance of the hands for the diagnosis and follow-up of rheumatoid arthritis].
Conventional radiography of hands has been the imaging technique used for the early diagnosis of rheumatoid arthritis, considering its easy access and ability to reveal structural damage. However, it does not provide information about inflammatory activity or prognosis of this disease. ⋯ This article reports the imaging protocol for magnetic resonance of the hands used at our institution for the diagnosis and follow-up of patients with rheumatoid arthritis. We also review the main imaging findings of the disease.
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Revista médica de Chile · Sep 2020
[Current situation of pediatric liver transplantation in Chile. Inequities associated with the MELD/PELD prioritization system].
The Chilean allocation system for liver transplantation (LT) uses the MELD/PELD score to prioritize candidates on the waiting list. ⋯ Pediatric candidates with chronic liver diseases, especially under two years of age, have greater access difficulties to CLT than adults. Half of the pediatric candidates die on the waiting list before three months. The mortality among candidates under two years of age in the waiting list is excessively high.
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We analyze the transmission routes, possible viral reservoirs in the oral cavity and considerations about dental care of SARS-CoV-2 virus infection. We also analyze the protocols required before and after a dental procedure, aiming to increase the awareness of dentists about the importance of virus spread prevention among health care workers and patients. ⋯ The tongue and oral mucosa are important viral reservoirs and the transmission of the virus occurs primarily by saliva droplets. Therefore, elective dental care should be postponed, attending only dental emergencies during this period, incorporating the use of protective personal equipment (PPE) and using manual instruments to prevent the production of aerosols.
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There is an important interindividual variability in dose requirement for coumarinic anticoagulants, which could be explained by genetic and non-genetic factors. Among hereditary factors, there are gene polymorphisms that code the therapeutic target and the main enzyme responsible for their metabolism. ⋯ Therefore, algorithms considering different variables to adjust individual dosages are required. Herein, we analyze the available evidence about factors that can modify the effects of vitamin K antagonists and that should be incorporated to dosing algorithms.
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Revista médica de Chile · Sep 2020
[Assessment of an asyncronic tele dermatology system for primary care physicians via social networking app WhatsApp].
In Chile, there is little access to Dermatology outpatient consultations in the public health care system, which has favored the development of tele dermatology (TD). ⋯ TD via a WhatsApp® group linked to a university is a low cost and easy to implement intervention, generating high levels of satisfaction among general practitioners.